Module 02

Lecture 01

The impact of diarrhoea

on nutritional status

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Impact of diarrhoea on nutritional status

short term effects

fluid (a liquid; a substance that can flow:

body fluids ( example, blood) loss

dehydration

electrolyte imbalance

medium to long term effects

malabsorption leading to malnutrition and growth

retardation
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Impact of diarrhoea
on nutritional status
The nutritional impact of diarrhoea operates
through at least four mechanisms

food intake

appetite loss

absorption

malabsorption

metabolism

altered metabolism

direct loss

nutrient loss

In addition, nutrient requirements are increased

during diarrhoea
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Impact of diarrhoea
on nutritional status
Food intake is affected by

appetite loss
result of clinical disturbance, dehydration,
electrolyte imbalance, fever, vomiting or
abdominal discomfort

Maternal (caring mother) behaviour

food-withholding behaviour as a response to
childs loss of appetite, or due to cultural
practices (refuse to give food during illness)

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Impact of diarrhoea
on nutritional status
Absorption is affected by

bacterial overgrowth

maldigestion

sugar fermentation

loss of absorbing surface

bacterial competition

transit time

bile metabolism

osmotic forces

micelle formation

enzyme loss

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Impact of foodborne diarrhoea

on nutritional status
Direct loss

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malabsorption and direct loss of

water and electrolytes because of
damage to the intestinal lining
protein - losing
increased bowel movements
accompanied by direct loss
of water and electrolytes

Growth pattern of a child with frequent

episodes of diarrhoea

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Impact of diarrhoea
on nutritional status
Pathogens

Water

Food intake

Food
Person
to
Person
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Absorption

Metabolis
m
Direct loss

Abdominal discomfort
Electrolyte imbalance
Fever
Vomiting
Dehydration
Bacterial overgrowth
Sugar fermentation
Bacterial competition
Bile metabolism
Micelle formation
Enzyme loss

Maldigestion
Transit time
Osmotic forces
Inductive effect
Loss of absorbing
surface

Anabolism / Catabolism
Protein - losing

Nutritional
Status

Intervention strategies for diarrhoea

1. Improved host defences

Three kinds of
interventions are:
1.improving host
defences.
2. therapeutic (cure)
intervention.
3. preventing
transmission.

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immunisation against
immunisable childhood diseases
nutrition

breast feeding
safe complementary food

micronutrients

Intervention strategies for diarrhoea

2. therapeutic (cure) intervention.
Therapy (treatment)
rehydration
intravenous ( )

oral
antibiotic
acute (
)
prophylactic (
)
feeding practice
convalescent (recovery) feeding
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Intervention strategies for diarrhoea

3. Prevention of transmission

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water
sanitation
household hygiene
food hygiene
personal hygiene
weaning food (gradually stop feeding)
isolation
disinfection

Key messages (1)

Acute and persistent (constant) diarrhoeas have
a significant effect on nutritional status in all age
groups
Mechanisms in operation affect

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food intake
absorption
metabolism
direct loss

Key messages (2)

Food intake may be affected by cultural

practices
Loss of appetite is a major barrier to
nutritional management of diarrhoea

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